The focus on outpatient follow-up of newborn infants increases as the duration of hospital stay after birth decreases. The first outpatient visit addresses the adequacy of the home transition. Appropriate ... [more ▼]

The focus on outpatient follow-up of newborn infants increases as the duration of hospital stay after birth decreases. The first outpatient visit addresses the adequacy of the home transition. Appropriate feedings are checked. Sudden infant death syndrome prevention and security advices are reminded. Realisation of both neonatal dried blood screen and hearing test is confirmed, as well as planning of specific follow-up appointments. The physical exam will focus on red flags for diseases or malformations with a delayed presentation. [less ▲]

Background A primary CPAP strategy is beneficial even in extremely preterm infants. Many still require intubation for stabilization. Half of those managed with primary CPAP will also require further ... [more ▼]

Background A primary CPAP strategy is beneficial even in extremely preterm infants. Many still require intubation for stabilization. Half of those managed with primary CPAP will also require further support: surfactant administration or mechanical ventilation, and have increased risks of death or neonatal morbidities, and will require longer respiratory support. Identifying them early, during the birth stabilization process, might lead to improvements in respiratory care. A subjective classification of perinatal adaptation as Good, Bad or Marginal has been suggested but not evaluated. Methods Single center retrospective study of <29 weeks premature infants admitted between 01/2013 and 07/2014. Neonatal database and discharge summaries provide neonatal care and outcome data. Good perinatal adaptation (GPA) is considered for infants with good respiratory drive, tone and low oxygen requirement in the delivery room. Infants with marginal (M) PA had intermittent respiratory drive, normocardia with ventilation, and decreasing FiO2. Bad (B) PA is considered with hypotonia, bradycardia, apnea and high FiO2. Results Among 58 infants (50 inborn), 16 had GPA, 19 MPA and 23 BPA. Risk factors for bad adaptation are (not significantly different-NS) male gender, lower GA , and absent/incomplete antenatal steroid exposure. Apgar score at 1 minute increases according to perinatal adaptation quality (B3,5; M5,5 and G7,4; p<0,01), with improvements at 5 minutes: 6,6; 7,0 (NS) and 8,3 (p(B)<0,01). Risk of intubation in the delivery room is associated with poorer adaptation: B83%, M58% and G12% (p<0,01). Primary CPAP success was not different according to groups (B 3/3; M66%; G56%). However, more infants with MPA received surfactant while on CPAP (LISA method): B 2/3; M:5/6 and G:4/7. This surfactant was given in the delivery room in 1, 4 and 2 infants respectively. For children intubated within day 3, the duration of the first invasive ventilation duration was 29 hours (B), 15h (M) and 9h (G), NS. Risk of early neonatal death decreases with improving perinatal adaptation: 26%, 16% (NS) and 0% (pB <0,05). Risk of BPD at 36 weeks is not different among groups (B 19%, M13%, G 12%), but combined risk of death or BPD at 36 weeks tends to decreases (B 43%, M 31%, G 12%, p=0,12). Conclusions Better perinatal adaptation improves chances of being initially managed with CPAP. CPAP success may be improved with less invasive surfactant therapy, especially in preterm infants with marginal adaptation. Perinatal adaptation assessment identifies mortality risk. [less ▲]

Cerebellar hemorrhage is a rare condition in full-term newborns. Early diagnosis based on the identification of risk factors, particular clinical signs and correct medical imaging is primordial to ... [more ▼]

Cerebellar hemorrhage is a rare condition in full-term newborns. Early diagnosis based on the identification of risk factors, particular clinical signs and correct medical imaging is primordial to optimize the immediate treatment and to assess the long term prognosis. [less ▲]

Appendicitis in the newborn is a rare but difficult diagnosis. Delayed diagnosis and a risk of complications as digestive perforation, peritonitis and sepsis are associated with a high mortality and ... [more ▼]

Appendicitis in the newborn is a rare but difficult diagnosis. Delayed diagnosis and a risk of complications as digestive perforation, peritonitis and sepsis are associated with a high mortality and morbidity risk. [less ▲]

Neonatal renal vein thrombosis is a rare condition. The present case is rather unfrequent and particularly educative since it shows the complete diagnostic triad including hematuria, flank mass and ... [more ▼]

Neonatal renal vein thrombosis is a rare condition. The present case is rather unfrequent and particularly educative since it shows the complete diagnostic triad including hematuria, flank mass and thrombocytopenia. The diagnosis relies on the demonstration, by Doppler ultrasound, of an obstructed renal venous bed. The investigation is completed by a platelet count and the determination of the prothrombin time, of the activated partial thromboplastin time as well as of the concentration of fibrinogen. The screening also includes the search for a possible etiology, such as a deficiency in coagulation proteins, the presence of antiphospholipid antibodies or of a genetic mutation of one of the coagulation factors. Since there exist no evidence based guidelines for the management of the disease, we will discuss the diagnosis and treatment in relation with the published literature. [less ▲]

Prader Willi syndrome can be viewed as a physiopathological model of obesity. Such patients deserve specific management, preferably in a multidisciplinary setting. The paper reports on 6 patients followed ... [more ▼]

Prader Willi syndrome can be viewed as a physiopathological model of obesity. Such patients deserve specific management, preferably in a multidisciplinary setting. The paper reports on 6 patients followed in the paediatric endocrine service at the University of Liege. [less ▲]